Researchers from the US reported a very rare case of a patient with oncocytic carcinoma of the thyroid (OCA) identified incidentally after a tracheostomy and subsequent biopsy, according to a recent case report.

“We have an opportunity to review this disease with the hope of improving outcomes by raising awareness and with early recognition,” the authors wrote in the journal Cureus.

OCA is an extremely rare type of cancer making up 3% to 5% of all thyroid cancers. It is an aggressive tumor and has a high risk of metastasis as well as a poor prognosis. Surgery is the only curative option but must be performed early before metastasis occurs. Medullary thyroid carcinoma is a type of oncocytic follicular cell-derived thyroid carcinoma. It accounts for 2% to 4% of all thyroid cancer cases.

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The case was that of an African American woman who had many other comorbidities. The patient was 72 years of age and lived in a nursing home. She presented to the emergency department with altered mental status. A computed tomography angiogram revealed type B aortic dissection as well as heterogeneous masses in both her femurs, consistent with bony metastases.

During tracheostomy, “a sizable left thyroid mass pushing the trachea to the right side,” was discovered, the authors noted. The patient then underwent a left hemithyroidectomy, which revealed multiple nodules in the thyroid tissue, the largest one of which consisted entirely of oncocytic cells that had a morphology consistent with OCA. After a definitive diagnosis, the patient underwent a total thyroidectomy and was discharged with thyroid hormone supplementation as she declined further cancer care.

“In order to recognize and treat the disease as early as possible, healthcare providers must consider the probability of OCA in patients presenting with a thyroid mass,” the study authors concluded.


Syed A, Vanka S, Escudero I, Ismail R, Krayem H. Oncocytic cell carcinoma of the thyroid: a case report and an overview of the diagnosis, treatment modalities, and prognosis. Cureus. 2022;14(10). doi:10.7759/cureus.30298